Vaccination pain management for adults: Guidance for health care providers

On this page

• Overview
• Improving the vaccination experience

Overview

Vaccination is important at every stage of life. However, for some people, vaccination can cause pain and stress, which can make them less likely to receive future vaccinations. Health care providers play an important role in a person’s decision to be vaccinated and their comfort during this process.

For optimal protection, it is important to review a patient’s vaccination record at every opportunity and offer any needed vaccines, especially those that may have been missed. 

As a health care provider, you have an opportunity to give people a positive experience by reducing vaccination stress-related responses, including:

• fear
• pain
• fainting

Building trust with your patients increases the likelihood of future vaccine acceptance for them and their families.

Learn more about:

• Not Just for Kids: An Adult Guide to Vaccination
• Immunization of adults: Canadian Immunization Guide

Improving the vaccination experience

There are a number of ways to make vaccine injections more comfortable for adults.

The CARD system is an evidence-based framework for delivering vaccinations that reduces stress-related responses. Each letter category incorporates strategies that reduce pain, fear and fainting.

Some examples include:

• Comfort: provide comfortable spaces for vaccination with available seating
• Ask: let people ask questions and address their concerns
• Relax: reduce the number of things that might scare them
• Distract: take attention away from the procedure for those who request it

Follow evidence-based practices for reducing pain from injection:

1. Select the appropriate needle length and gauge to minimize pain.
2. If giving multiple separate injections, start with the vaccine that causes the least amount of pain or discomfort.
3. Do not aspirate during injection.
4. Inject vaccines quickly.

Learn more about:

• Needle selection guidelines

Muscle tension technique

If a patient feels dizzy or faint during an injection, have them squeeze the muscles in their legs and stomach. Ask them to keep squeezing for 10-15 seconds until their face feels warm. Have them relax for 20-30 seconds and then ask them to repeat a few times or until the symptoms go away. Alternatively, they can lie down during the procedure.

Needle fear

If a patient has a high level of needle fear, consider referral to a mental health expert, such as a psychologist. Treating needle fear can help alleviate the stress that is sometimes associated with needles. Overcoming needle fear will increase comfort and help patients to be more accepting of future vaccinations and other needle procedures.

Related links

• Immunization stress-related responses (PDF, World Health Organization)
• Techniques to decrease immunization injection pain (Canadian Immunization Guide)
• Reducing pain at the time of vaccination: WHO position paper (PDF, World health Organization)
• Clinical Practice Guideline on management of vaccination pain (from birth to adulthood) [PDF, Canadian Medical Association Journal]
• Communicable Disease Control Manual: Reducing Immunization Injection Pain (PDF, BC Centre for Disease Control)
• Meeting of the Strategic Advisory Group of Experts on immunization: Conclusions and recommendations on reducing pain and distress at the time of vaccination (PDF, World Health Organization)